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1. Alternative Medical Systems
   Alternative medical systems are built upon complete systems of theory and practice. Often, these systems have evolved apart from and earlier than the conventional medical approach used in the United States. Examples of systems that have developed in non-Western cultures thousands of years ago include traditional Chinese medicine, which consists of acupuncture, massage, herbs, diet and meditative physical exercise, and Ayurveda (niam.com/corp-web/index.htm). Examples of alternative medical systems that have developed in western cultures include homeopathic medicine and naturopathic medicine, which may include dietary modifications, massage, exercise, acupuncture, minor surgery and various other interventions.
2. Mind-Body Interventions
   Mind-body medicine uses a variety of techniques designed to enhance the mind's capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioral therapy). Other mind-body techniques that are still considered CAM, include meditation, prayer, mental healing, and therapies that use creative outlets such as art, music, or dance.
3. Biologically Based Therapies
   Biologically based therapies in CAM use substances found in nature, such as herbs, foods, and vitamins. Some examples include dietary supplements, herbal products, and the use of other so-called "natural" but as yet scientifically unproven therapies. In 1994, Congress defined "dietary supplement" as a product (other than tobacco) taken by mouth that contains a "dietary ingredient" intended to supplement the diet.
4. Manipulative and Body-Based Methods
   Manipulative and body-based methods in CAM are based on manipulation and/or movement of one or more parts of the body. Some examples include chiropractic or osteopathic manipulation, and massage.
5. Energy Therapies
   Energy therapies involve the use of energy fields. They are of two types:
   • Biofield therapies are intended to affect fields that purportedly surround and penetrate the human body. Some forms of energy therapy manipulate biofields by applying pressure and /or manipulating the body by placing the hands in, or through, these fields. Examples include Therapeutic Touch (www.therapeutic-touch.org/content/ttouch.asp) Reiki and qi gong.
   • Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields, such as pulsed fields, magnetic fields, or alternating current or direct current fields.

• The healing power of nature — Probably the most important difference between conventional and alternative medicine is that alternative medicine is founded on a deep belief in the healing power of nature. Alternative medical providers accept that within us is a natural ability to heal, an inherent recuperative power that is the key to all healing. The alternative practitioner believes his or her job is to support and stimulate this natural healing ability inherent in each patient.
• Patient centered rather than physician centered — High quality alternative medicine is first and foremost "patient centered," in which the feelings, beliefs, and the opinions of the patient are essential elements in the treatment decision-making process. Whereas, conventional medicine has come to see the patient as his or her diagnosis rather than as an individual.
• Results usually take longer — One primary goal of alternative medicine is to stimulate the body's natural healing response and to let nature take its course. From this process, a true healing can occur, increasing the chances that the symptoms will not return. Some people find the slower rate of recovery frustrating if they are accustomed to immediate results from conventional medical treatments.
• Use natural and whole substances — Many alternative treatments use natural substances such as herbs, botanicals, homeopathics, nutritional supplements, and whole foods. There is a general belief among naturopathic doctors that the use of whole or natural products to treat maladies adds more to the healing process than their synthesized counterparts. While many synthesized pharmaceuticals may be more potent and fast-acting, they also often come with unpleasant side effects.
• Higher standard of health — For many years, health was seen as "the absence of disease" by conventional medical doctors. The common philosophy was: If you are not sick and you do not need to go to the doctor's office or the hospital, then you must be healthy. In years past, people would go to their conventional doctors for an annual check up and be given a clean bill of health. An individual's health was assessed by the results of the physical examination. Little, if any, consideration was given to lifestyle factors such as diet, exercise, or personal or psychological issues. Minimal concern was generally given to the emotional, mental, spiritual, and social aspects of the person.

• Reliable information can be found by searching the Internet. The Ask Noah About: Complementary and Alternative Medicine Web site www.noahhealth.org/english/alternative/alternative.html provides a listing of various therapies. Each therapy listed contains a listing of several Web sites about that particular therapy and additional resources. The Alternative Medicine homepage operated by Falk Library of the Health Sciences at the University of Pittsburg contains a compilation of Web sites concerning complementary and alternative therapies www.pitt.edu/~cbw/syst.html.
• Reliable information can be found by searching directories in libraries (ask the librarian) or on the Internet. One directory is the Directory of Information Resources Online (DIRLINE) compiled by the National Library of Medicine, dirline.nlm.nih.gov. It contains location information about a variety of complementary and alternative therapies.
• The National Center for Alternative and Complementary Medicine (NCCAM) does research on complementary and alternative medicine (CAM). Results of their research can be found on their Web site nccam.nih.gov/ or you can contact them toll free at (888) -644-6226.

• Contact the American Holistic Medical Association (AHMA) , holisticmedicine.org/. AHMA consists of licensed physicians who practice holistic medicine. Their vision is to transform health care so that it addresses the physical, environmental, mental, emotional, spiritual and social health needs of the patient. Currently, the AHMA has a directory of providers, which you can order for $15. The address for AHMA is in the resource section. In May 2003, an online directory will be available.
• Contact a professional organization representing the type of practitioner for which you are seeking. Often, professional organizations have standards of practice, provide referrals to practitioners, have publications explaining the therapy (or therapies) that their members provide, and may offer information on the type of training needed and whether practitioners of a therapy must be licensed or certified in your state.
• Professional organizations can be located by searching the Internet or directories in libraries (ask the librarian). One directory is the Directory of Information Resources Online (DIRLINE) compiled by the National Library of Medicine, dirline.nlm.nih.gov. It contains locations and descriptive information about a variety of health organizations, including CAM associations and organizations. You may find more than one member organization for some CAM professions.
• Many states have regulatory agencies or licensing boards for certain types of practitioners. They may be able to provide you with information regarding practitioners in your area. Your state, county, or city health department may be able to refer you to such agencies or boards. Licensing, accreditation, and regulatory laws for CAM practices are becoming more common to help ensure that practitioners are competent and provide quality services.
• Ask your doctor or other health professionals whether they have recommendations or are willing to make a referral. Also, contact your local medical or hospital. With some medical schools offering classes in alternative medicine, they may even have practitioners on staff.

• Referral Source — How did you hear about this practitioner? What do friends and other professionals say about this person?
• Training and Credentials — What are the credentials of the practitioner? If there isn't any credentials for their type of therapy, then ask how many training hours have they accumulated?
• Professional Associations — Are they members of a credible professional organization such as the American Massage Therapy Association (AMTA) or North American Society of Homeopaths (NASH)?
• Response of the practitioner's office and staff — Do you feel comfortable when you call or visit the office? Does the staff tell you about the practitioner — how long they have been in practice, fee schedules, insurance and what can I expect on my first visit?
• Being a partner with the practitioner — Does the practitioner seem to care about you, take your medical history personally and show an interest in your family, lifestyle and diet? Are you told about various treatment options? Do you have input to the course of treatment? Does the practitioner take time to answer questions? Is the practitioner accessible?
• Refer other family members or friends — Would you feel comfortable referring other family members or friends to this practitioner?

• www.icmedicine.co.uk/whatiscm.htm
• www.faim.org/glossary.htm

Complementary and Alternative Medicine (CAM) facts:

• www.faim.org/facts.htm

For more information about health topics or conditions:

• www.noah-health.org/english/qksearch.html
• nccam.nih.gov/health/bydisease.htm

For more information about therapies:

• www.rosenthal.hs.columbia.edu/Grid.html
• nccam.nih.gov/health/bytreatment.htm
• www.ohsu.edu/ohmig/cam.html#ther
• www.noah-health.org/english/alternative/alternative.html

Professional associations and organizations:

• www.medbioworld.com/cgi-bin/displaycontents.cgi? table=med&type=Associations&filecode=(M)%20Complementary

Licensed physicians who practice holistic medicine:

• holisticmedicine.org/

Training for Complementary and Alternative Medicine (CAM)

• Academic Institutions
  www.ohsu.edu/ohmig/cam.html#acad
• Complementary and Alternative Medicine courses taught at U.S. Medical Schools
  www.rosenthal.hs.columbia.edu/MD_Courses.html
• The Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine, Columbia-Presbyterian Medical Center
  www.rosenthal.hs.columbia.edu/index.html

History of Complementary and Alternative Medicine (CAM) in the U.S.:

• www.faim.org/legal.htm

Questions and Answers concerning Complementary and Alternative Medicine (CAM):

• www.healthy.net/asp/templates/article.asp?PageType=Article&ID=510